Duration numbers and P.R.'s Danielle Kurtz Laban reports one centerpiece of Joe Biden's plan is a grant program intended to encourage states to invest in crime prevention as opposed to incarceration he also says he would allocate 1000000000 dollars per year toward juvenile justice reform the plan reaches across several major policy areas with proposals to decriminalize cannabis eliminate the death penalty at the federal level and expand pre-K. Access Biden's plans for criminal justice changes also include gun control measures such as universal background checks and a ban on assault style weapons his proposal comes a week ahead of the next Democratic debates which will feature 20 candidates he will take part in the 2nd night of the debates Daniel Kurtz Lavan n.p.r. News the Senate Finance Committee says there's a bipartisan deal between panel leaders to lower prescription drug prices Committee chairman crassly and the panel's top Democrat Ron Wyden will jointly present their plan to the full committee Thursday it would improve incentives to increase negotiation between drug plans and manufacturers the Dow up 47 this is n.p.r. News. In advance of testimony tomorrow on Capitol Hill former special counsel Robert Muller hasn't struction from the Justice Department not to stray beyond his official report on Russian election interference that in response to a request for guidance from Muller of particular concern redacted material in the report especially related to pending criminal prosecutions uncharged 3rd parties and executive privilege such as presidential communications privileges Muller's testifying before 2 committees tomorrow and separate sessions the House judiciary committee and House intelligence. Some birds are doubting to climate change but probably not fast enough for their species to survive according to new research we get details from N.P.R.'s Victoria ridge she is an ecologist at the lightness Institute and Berlin and she wanted to see how animals around the world were responding to climate change I've been going to expect that they would adapt but in looking through dozens of bird studies she found that some are starting to lay their eggs and migrate earlier this makes them more ready for the early onset of spring which is an effect of climate change that fad their behavior wasn't changing very quickly so in one day about the base of this is not sufficient to keep. A base of climate change rejects says this means that many bird species are risk of extinction if climate change continues and it's expected pay if she encourages people to take steps to help and her study is published in Nature Communications paying long n.p.r. News I'm Louise Schiavone n.p.r. News Washington support for n.p.r. Comes from the financial services firm of Raymond James offering personalized wealth management advice and banking and capital markets expertise along with a legacy of putting clients financial wellbeing 1st learn more at Raymond James dot com. Solar energy has taken off across the u.s. Now Nashville native Jason Carney wants black communities to know if the energy savings and the green jobs are yours to be had no one controls to sell. Their support could they would get that care right now all you need is knowledge I married spreading solar in Nashville this afternoon on All Things Considered from n.p.r. News today for support comes from a Lifelong Learning Institute at u. Conn Waterbury. This is Fresh Air I'm Terry Gross our guest actor guy Leshner writes that you can survive longer without food than without sleep as a sleep disorder specialist he's seen plenty of patients with insomnia and just about every other kind of nocturnal problem night terrors narcolepsy sleep apnea sleepwalking sleep eating sleep driving and something called sexsomnia in his new book he describes some of his more challenging cases and the growing body of research into sleep and sleep problems guy less than yours a neurologist and head of the Sleep Disorder Center at Guy's Hospital in London he spoke to Fresh Air's Dave Davies about his new book The nocturnal brain nightmares neuroscience and the Secret World of Sleep Dr Guy less than her welcome to Fresh Air You've got some fascinating cases in this book but before we get to them I want to just cover a couple of basics a lot of us have heard of rapid eye movement sleep you know rem sleep where are our balls are darting rapidly and then there's none right rapid eye movement sleep non rem sleep if you want to just explain the differences between these 2 kinds of sleep well if one looks at the brain during sleep we now know that actually sleep is not a static status not a simple binary state whereby we're either awake or asleep what we now know is that actually there are a number of different brain states that occur while we sleep and we tend to devolve develop those brain states they sleep states into as you say read and will repeat on movement sleep and. Sleep in rem sleep actually when we look at the brain the brain from an electrical point of view looks to be very very active in fact the brain waves look very much like the brain waves of an awake brain and it's during this stage of sleep that we associate dreaming to occur particularly those. Dreams of a narrative structure plots evolving over night and during that stage of sleep when the brain is very active Actually it's probably when we are most separated from our bodies in fact although in this stage of sleep the our eyes dart back and forward pretty much every single muscle in our bodies apart from the muscles that control our eyes are completely paralyzed whereas in non rem sleep when we look at the brain waves the brain waves are slow to the large this is less associated with dreaming although we do dream of sorts in nonrandom sleep and it seems that these 2 different types of sleep probably have rather different functions Yeah what are the different functions Well I think the short answer to that is that we don't fully know we think that rem sleep is particularly important depending on the stage of life in the development of consciousness in learning in creativity in emotional processing where as non rem sleep is perhaps the stage of the stage of sleep during which those restores have functions that impact the brain and also impact the body occur so things like cleansing out toxic metabolites from the brain regulation of the immune system and a variety of other functions so it's the non rem sleep that people refer to as deep sleep right that it well not rem sleep in compass is this slightly different stage of sleep where the arm movements don't all back and forward but within on rem sleep there exists what we term stage one stage 2 and stage 3 sleep and stage 3 Sleep is a very deep sleep that we associate with waking up feeling restored feeling refreshed Ok let's talk about some of the disorders that confront you and Clay sleepwalking is one and you've had some patients with some pretty strange episodes you want to share a couple of them yes the one that always comes to mind 1st. Paul is is the 70 year old woman that I saw a few years ago who would be found to be driving up and down the seafront in her local town in the middle of the night and in fact in in earlier life she had had a motorbike and had been seen riding her motorbike apparently in her sleep and even at an earlier stage she was brought up in Canada and she would often go into the wilderness with the guides on camp and would wake up her tent mates groundling very loudly in the middle of the night of course they thought that they were being attacked by a grizzly bear and so she was soon sent back home because of the terror that she triggered in all her colleagues so so that's that's one example but. The sleepwalking or conditions associated with sleep walking real can really manifest in a number of ways and these include sleep terrors where people wake up in the middle of the night absolutely terrified screaming and shouting and then go back to sleep often with very little recall and then there are some some other conditions things like sexsomnia which is sexual behavior him sleep so sometimes these conditions sound very funny and and indeed can be very funny but on other occasions they can be really life changing resulting in in major injury or as one of the cases I describe in the book in a criminal conviction rate and in all you had another guy you had a patient Alex who had got an order Peters and then none of them do any of them remember any of this after the fact well we used to think that people don't really remember any thing that occurs in this stage that seems to relate to the fact that the brain in parts is in very deep sleep whilst another parts is awake what we have learned over the last few years is that actually quite a lot of people have some sort of eliminated recall they don't necessarily remember the details of of all the. And sore indeed the entire 80 of the event but sometimes they do experience a little snippet So Alex who you referred to would also do things like distribute glasses of water around the house for his sleeping flatmates without any recollection but those events that were associated with a much stronger emotional content so natural disasters on one occasion he dragged his girlfriend out of bed in the middle of the night because he thought that a tsunami was about to wash them away and those kinds of events with strong emotional context are often better remembered right so this category of sleep problem this is no ram parasomnia This is from the sleep where your eyeballs are not darting about. What do scientists think is going on when this happens well I talked earlier about the fact that we no longer consider sleep to be a binary state an on or off state but warts sleepwalking in particular tells us is that sleep is also not a global state and what I mean by that is that the whole of the brain. Is not necessarily in the same stage of sleep at the same time so that individuals who exhibit this group of disorders called an on ramp parasomnia as these unwanted behaviors that arise from non ram sweet typically the very deeper stages of nonrandom sleep what we see by either scanning them while they're exhibiting these behaviors or sometimes with electrodes is that certain parts of the brain can remain in very deep sleep in the pulse of the brain that in particular remain in very deep sleep or the frontal lobes which are that are the seat of our rational thinking on our planning are. Restricting on normal behaviors where as other parts of the brain can exhibit electrical activity that is really a kin to being wide awake so in particular the parts of the brain that are responsible for motion an area of the brain called the limbic system obviously. The the parts of the brain that responsible for movement and it's this dissociation this this disconnect between the different parts of the brain in terms of their sleep stages that actually give rise to these sorts of behaviors Ok so a part of our brain is sleeping soundly and some other part for some reason is around us and functioning Do we know why this happens. We know that sleep walking and these related conditions seem to run very strongly in families so there seems to be some sort of genetic predisposition to being able to enter into this disconnected brain state. And we know that anything that disrupts your sleep if you have that genetic predisposition can give rise to these behaviors So for example I've seen people who have had some new events triggered by the fact that they sleep in a creaky bed in their bed partner is rolled over sometimes or a large truck driving past in the street outside the bedroom but there are also internal manifestations internal processes that can give rise to these partial awakenings So for example snoring or more severe than snoring sleep apnea where people stop breathing in their sleep occasionally other sleep disorders like a condition called periodic limited disorder where people kick and so anything that causes a a change in the depth of sleep in people who are predisposed to this phenomenon of being in multiple sleep stages at the same time can give rise to these behaviors and we think that it's probably a throwback to certain evolutionary mechanisms so for example if you look at certain animals particularly aquatic mammals and certain species of birds they can sleep with only one half of their brain at the same time because that allows them to swim or to surface for air. Or to carry on flying whilst they are asleep and and so it's well established that having different parts of the brain in different stages of sleep occurs in nature and so it may be that this is a bit of an evolutionary hangover for us right you mention that it manifests in sleepwalking sleep driving sleep eating and something you refer to as sexsomnia you want to tell us what that is what your patients are exhibit so sex on near is really a type of normal Rem parasomnia that manifests with sexual behavior in the range of sexual behavior can be quite broad but it at its extremes that can result in people trying to pursue full blown sexual intercourse in sleep we used to think of sex on mirrors being a relatively rare phenomenon but actually whenever I do anything like this on the radio will write about it I'm usually inundated by e-mails or messages saying oh yes I do that and actually in the sleep lab if you directly also people about sex or near a lot of people actually will actually report it but they don't tend to go to their doctor with it because for most people it's not a particular problem where it does get to be a major problem is if it results in unwanted sexual behavior usually when you are sharing a bed with somebody who is not your regular partner and as I describe in one of the cases one of my patients ended up convicted of rape as a result of one of these events for a lot of people these 9 Rem parasomnia these are these these conditions can create serious problems so people for people like Jackie who was driving around in our neighborhood or Alex who was ordering pizzas. How are you how do you treat them. Well I think the 1st question is whether or not they want specific treatment as a as I talked about in the book with Jackie actually the reason why Jackie came to see me is because. She was worried about the fact that she was driving up and down her sea front in the middle of the night and thought that she might be a danger to herself and to other people and it was when she went to her family practitioner that she was told Well actually the only the only way to manage this might be to get her admitted into an inpatient secure psychiatric unit but actually she had gone through her life seeing this is very much part and parcel of who she was and she actually hit upon her own way of trying to manage this in that she bought herself a time locked safe why she would deposit her car keys and knew that she could not get her car keys out of the safe until 6 o'clock in the morning thus treating herself very well for people who are putting themselves at risk or putting other people at risk there are range of things that we can do the 1st thing is to try and optimize sleep generally because in people who are sleep deprived that in itself can pry him the brain for developing these sorts of behaviors but for more extreme cases and if that doesn't work then dealing with anything else that might be disrupting their sleep looking at their environment looking to see whether or not they snore and treating those issues is often a very successful way of dealing with these sorts of problems in very few cases when people are really putting themselves at risk then we will resort to certain types of medication to try and treat these sorts of events all kinds of medication Well the sorts of treatments that have been demonstrated to work include drugs like melatonin in certain instances benzodiazepines like clonazepam and also a range of antidepressant drugs now all of these drugs have potentially serious short and long term side effects so in any individual there are risks and the benefits of treating them with medication need to be weighed up very carefully so you manage it behaviorally if you can. And I think the. That's the case for many sleep disorders if we can avoid medication that would be the optimal way of managing these conditions. Is a neurologist and sleep disorder specialist His new book is called the nocturnal brain We'll talk more after a short break this is Fresh Air So what if I told you there's a way to save millions of lives the most beautiful invention it can save over $600000.00 children every year now what if you found out this wasn't some expensive high tech machine but one of the world's inventions washing hands with soap because sometimes the best solutions are the simplest ones that's next time on the Ted Radio Hour from n.p.r. . Tonight at 11 o'clock. This is Fresh Air and we're speaking with Dr Guy Leshner he is a neurologist and head of the Sleep Disorder Center at Guy's Hospital in London his new book is the nocturnal brain nightmares neuroscience and the Secret World of Sleep. Sleep apnea is an issue that really trouble some people what exactly is it a. Sleep apnea describes the phenomenon of on their way collapsing down in sleep so our airway is essentially a floppy t. That has some rigidity some structure to it as a result of multiple muscles and as we drift off to sleep those muscles lose some of their tension and the airway becomes a little bit more floppy now when it's a little bit floppy and it reverberates as we breathe in during sleep that will result in snoring the reverberation of the walls of the airway result in the noise but in certain individuals the airway can become floppy enough or is narrow enough for it to collapse down and to block or flow as we're sleeping. It's normal for that to occur every once in a while for everybody but if it occurs very frequently the what happens is that sleep can be disrupted sometimes 10 sometimes 20 sometimes even $100.00 times an hour because as we drift off to sleep the airway collapses down our oxygen levels drop our heart rate increases our brain wakes up again and our sleep is essentially being disrupted and then the airway becomes a little stiff and they then gradually start dozing off to into deeper stages of sleep and the cycle continues and you say that we're seeing an epidemic of sleep apnea. Yes So. As all girths as all weights increase the incidence of obstructive sleep apnea also increases sleep near is very strongly associated with obesity in the. That weight on the throws tore on the chest fat being deposited within the muscles in our throat can often result in our airway becoming narrower or actually be losing structural rigidity more easily so as we as a population get larger obstructive sleep apnea gets worse and the issue is beyond simply that of feeling sleepy because one's had one sleep disrupted all the way through the night we are now aware that obstructive sleep apnea has a range of long term implications on our health in terms of high blood pressure in terms of risk of cardiovascular disease risk of stroke impact on or a cognition so our mental clarity and there is now a emerging body of evidence to suggest that actually obstructive sleep apnea may be a factor in the development of conditions like dementia now there is this treatment this you know fairly invasive treatment where you wear a mask the c pap right it's called continuous positive airway pressure where it keeps putting pressure putting some air pressure in your mouth so that the airway doesn't collapse. That's not the easiest thing to deal with both for you and your sleep partners right it is a challenging piece of kit for many people I think on the plus side individuals with sleep apnea often feel transformed by the use of this